Operationalizing Alternative Payment Models and Modernizing Settlement at Scale with NASCO Evolve

How Blue Cross Blue Shield of Michigan Reduced Settlement Time from Weeks to Minutes

Executive Summary:

Blue Cross Blue Shield of Michigan (BCBSM) manages more than 200 alternative payment model (APM) arrangements across millions of members. As its value-based care strategy expanded, so did the operational complexity of managing settlements.

Manual, spreadsheet-based processes became increasingly difficult to scale, requiring weeks to complete calculations, limiting transparency and timely performance insights, and creating dependency on institutional knowledge.

After searching for a technology enablement partner, they found the right one in NASCO Evolve. Through this partnership, BCBSM transformed its settlement operations, reducing processing time from weeks to as little as 15 minutes, improving auditability, and enabling scalable growth without increasing operational burden.

The Challenge:

Scaling APM Complexity

As a national leader in value-based care, BCBSM has built one of the most advanced APM portfolios in the country. By 2024, the organization was managing more than 200 arrangements across lines of business, including full-risk Medicare Advantage, shared savings programs, bundled payments, and specialty partnerships.

As each arrangement is unique, structured with different metrics, financial models, and contractual terms, this “snowflake” reality creates significant operational complexity. While innovation accelerated at the contracting level, settlement operations struggled to keep pace.

• Data was processed across dozens of Excel models
• Settlement logic was built and maintained in spreadsheets
• Reporting and adjustments were handled manually

The Provider Financial Analyst (PFA) teams, a team of approximately 10 analysts alongside their IT counterparts, worked diligently to ensure settlements were accurate and timely. But the process was labor-intensive, highly dependent on institutional knowledge, and difficult to audit. Producing a single settlement often required up to three weeks, while onboarding new arrangements could take months. As the organization expanded into more advanced, risk-bearing models, it became clear that manual processes could not support the scale required for the future.

The Solution:

Purpose-Built Settlement Infrastructure

BCBSM needed more than incremental improvements, it needed a modern platform designed specifically for settlement at scale. With NASCO Evolve, BCBSM implemented a cloud-native solution purpose-built to handle the complexity of APMs without forcing standardization.

Key benefits of NASCO Evolve included:

• First Purpose-Built System of Record for APM Program Administration: Provides the operational infrastructure and financial controls to confidently administer, scale, and defend the entire APM portfolio and also the transparency to show how providers can succeed in value-oriented incentives.
• Pay Accurately, Every Time: Administers and settles provider payments accurately across the APM portfolio with speed and auditability.
• Contract-First Design: Built from each unique contract, not a template, NASCO Evolve closes the gap between contract terms and what gets paid, with logic behind every payment decision.
• Cloud-native, AI-Powered Contract Ingestion: Extracts key contract terms, supporting complex logic and variability.
• Source-System Agnostic: Works with existing claims systems without requiring additional technology investment. 

Implementation:

A Collaborative, High-Stakes Implementation

Formal engagement began in early 2025, when NASCO Evolve was still in its Beta phase. BCBSM became the lighthouse customer, working alongside NASCO as a co-innovation partner. Cross-functional collaboration included BCBSM IT and Architecture, Healthcare Value and Contracting leadership, PFA operational teams, and NASCO Product, Engineering, and Architecture.

The initial implementation included:

• 21 Medicare Advantage full-risk arrangements
• Over 200K member lives
• Cross-functional teams spanning finance, actuarial, contracting, IT, and operations

Given prior vendor experiences, the project was viewed internally by BCBSM as high risk. Each phase refined functionality, validated calculations, and strengthened operational readiness. Following three phases of rigorous testing and validation, the platform went live on schedule in January 2026.

“Leading into go-live with NASCO Evolve, my confidence was high due to our robust collaboration with NASCO and the rigor of the three phases of User Acceptance Testing (UAT); go-live went even better than I anticipated as has dual mode.” – Alan Byrnes, Director of HCV Analytics & Insights (BCBSM)

The Impact:

From Manual Execution to Operational Intelligence

The impact of NASCO Evolve was immediate and transformational. For the first time, BCBSM can systematically measure settlement cycle time and identify bottlenecks.

• Settlement Speed: What previously required weeks can now be completed in as little as 15 minutes, which represents up to a 99.95% reduction in processing time.
• Accelerated Onboarding: New arrangements can be onboarded in days—or in some cases, minutes, significantly reducing time to value.
• Operational Efficiency: Manual spreadsheet-based workflows have been replaced with a scalable, automated platform, reducing reliance on labor-intensive processes and institutional knowledge.
• Team Transformation: Analysts have shifted from manual execution to higher-value work—focusing on performance insights, contract optimization, and advancing affordability initiatives.
• Auditability & Transparency: For the first time, BCBSM has full traceability across settlement operations which enabled faster resolution of disputes and stronger compliance. This full traceability included, data sources used, contract versions applied, and calculation logic executed.

Increased Settlement Speed by 99.95%, Moving from Weeks to Minutes.

Strategic Impact:

Enabling the Next Decade of Affordability

By the end of 2026, BCBSM expects roughly 80% of its APM arrangements to be live on NASCO Evolve. Today the platform is impacting close to 2M member lives.  

NASCO Evolve is not simply an efficiency tool, it is foundational infrastructure for affordability. For providers, timely insights highlight how they can succeed in value-oriented incentives and impact the cost of the care. By reducing administrative burden, mitigating operational risk, and enabling scale without linear increases in staffing, NASCO Evolve supports BCBSM’s broader mission to deliver high-quality, affordable care.

As payment models continue to evolve, scalable operational infrastructure will define which health plans can innovate with confidence.

Conclusion:

BCBSM’s partnership with NASCO demonstrates that even the most complex, enterprise-scale APM operations can be modernized. With the right infrastructure, health plans can move beyond manual processes to achieve speed, transparency, and scale, unlocking new opportunities to drive affordability and improve outcomes.